老年胆道疾病合并肝硬化门脉高压症手术治疗适应症分析  

Elderly biliary diseases combined cirrhotic portal hypertension surgery indications analysis

作　　者：孙源 

机构地区：[1]辽宁省朝阳市中心医院普外科,朝阳122000

出　　处：《肝胆外科杂志》2015年第4期270-272,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨胆道疾病合并肝硬化门脉高压症的手术适应症,针对手术适应症制定手术方案并分析术后处理及治疗效果。方法选择胆道疾病合并肝硬化门脉高压症老年患者37例为研究对象,在分析手术适应症的基础上分为A、B、C三组,A组11例患者行择期脾切除术、胆囊切除加贲门周围血管离断术,B组14例患者行门静脉与下腔静脉端侧分流术合并胆囊切除,C组12例患者行远端脾——肾静脉分流术,分析各组患者术后处理方法及治疗结果。结果手术基本情况组间比较差异无明显的统计学意义(P>0.05);A组总有效率为90.91%,B组总有效率为78.57%,C组总有效率为66.67%,总有效率组间两两比较具有明显的统计学差异(P<0.05);A组术后出血、门脉压、术后发热各1例,B组术后出血2例、门脉压3例、术后发热3例,C组术后出血3例、门脉压5例、术后发热2例,组间两两比较具有明显的统计学差异(P<0.05)。结论严格掌握手术适应症,注重手术技巧,老年胆道疾病合并肝硬化门脉高压症外科手术治疗是安全有效的,选择择期脾切除术、胆囊切除加贲门周围血管离断术治疗效果最佳。Objective To explore biliary diseases combined liver cirrhosis portal hypertension surgery indications,surgical indications for surgery,analysis of postoperative treatment and therapeutic effect. Methods Select combined cirrhotic portal hypertension in elderly patients with biliary tract disease 37 cases as the research object,on the basis of analysis of vitreoretinal surgery is divided into three groups A,B,C,group A line 11 patients undergoing elective splenectomy,gallbladder excision plus cardiac blood vessels around from broken,B group of 14 cases of patients with portal vein and inferior vena cava end side bypass merger gallbladder excision,12 cases patients of group C distal spleen-renal vein bypass surgery,analysis groups of patients with postoperative treatment methods and treatment outcome. Results Basic situation comparative differences between groups with no obvious statistical significance( P> 0. 05); A group total effective rate was 90. 91%,B group total effective rate was 78. 57%,total effective rate of group C was 66.67%,total effective rate between two groups compared with significant statistical difference( P < 0. 05); Group A postoperative bleeding,portal vein pressure,1 cases of postoperative fever,group B postoperative hemorrhage 2 cases,3 cases of portal vein pressure,postoperative fever( 3 cases),postoperative hemorrhage( 3 cases),portal vein pressure group C in 5 cases,2 cases of postoperative fever,between the two groups compared with the two significant statistical difference( P < 0. 05). Conclusion Master the operation indications strictly,pay attention to the operation skill,elderly biliary diseases combined liver cirrhosis portal hypertension surgery is safe and effective,choose elective splenectomy,gall bladder resection for the treatment of cardiac blood vessels around from broken effect is best.

关 键 词：胆道疾病 肝硬化 门脉高压症 外科手术 手术适应症 

分 类 号：R657.34[医药卫生—外科学]